The nurse sees that a patient with a chest tube has intermittent bubbling in the water-seal chamber 4 hours after the chest tube was inserted. What action by the nurse is most appropriate at this time?
a. Notify the physician.
b. Check for an air leak.
c. Listen to the lung sounds.
d. Document the findings.
D
Intermittent bubbling is expected while air is being evacuated from the pleural cavity. The actions of notifying the physician, checking for an air leak, and listening to the lung sounds are not required since the chest tubes appear to be functioning correctly.
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A mother brings her 12-month-old son into the clinic for his MMR vaccination. What would the clinic nurse advise the mother about the MMR vaccine?
A) The mother should be advised that photophobia and hives might occur. B) The mother should be advised that there are no documented reactions to an MMR. C) The mother should be advised that fever and hypersensitivity reaction might occur. D) The mother should be advised that hypothermia might occur.
When teaching family members to care for the patient with dementia, the nurse must be sure that they understand two important concepts, which are that the patient usually:
1. forgets things relatively quickly and is usually unable to learn new things. 2. can remember new tasks but will forget any previously taught tasks. 3. cannot learn new information but will probably remember anything you ask about the past. 4. responds well to reality orientation and needs to have a flexible schedule.
A student is studying for an upcoming test. She has read the assigned text once and is now ready to highlight. Which actions by the student indicate that she understands how to highlight? (Select all that apply.)
a. Uses circles to highlight key words or phrases b. Draws an asterisk next to an important paragraph or sentence c. Underlines sentences of importance d. Draws squares around words for emphasis e. Marks a section with a star for future reference
Healthcare institutions are frequently the site of conflict. Which of the following situations exemplifies interpersonal conflict?
A) A nurse is undecided whether to pursue a management position or to continue providing bedside care. B) A recent graduate and a more experienced nurse disagree on the thoroughness of the recent graduate's assessments. C) A cohort of experienced nurses have concerns about the way that younger nurses dress and present themselves. D) The nurses on a unit are having difficulty getting physicians to return pages.